It is well known in the art to use implantable annuloplasty suture guides for surgical correction of certain mitral or tricuspid heart valve disorders. The heart has two atrio-ventricular valves. The mitral valve is on the left side of the heart and the tricuspid valve is on the right side of the heart. Both valves are subject to damage that requires the valves to be repaired or replaced. Clinical experience has shown that repair of the valve, where this technique is possible, produces better long term results than does valve replacement. The mitral and tricuspid valves differ significantly in anatomy. The annulus of the mitral valve is somewhat D-shaped and the annulus of the triscupid valve is more nearly circular.
Wright et al, U.S. Pat. No. 5,674,279, the contents of which are expressly incorporated by reference herein, describes in detail various effects of valvular dysfunction, known corrective procedures and various prostheses that have been used in conjunction with mitral or tricuspid valve repair. Wright is also directed to an annuloplasty and suture ring structure that has experienced considerable success in mitral and tricuspid valve repair.
Known prosthethis are either completely flexible or have an internal frame in at least a portion of the annuloplasty ring to impart some structural integrity. Those annuloplasty rings having an internal frame can be difficult to install if there is even slight deviation in patient anatomy in the vicinity of an annulus defined by tissue surrounding a human heart valve. Thus, this is one limitation on Carpenter et al. D-shaped closed rings discussed on the Wright '279 patent. Other rings are flexible, such as the Cosgrove-Edwards band which is a fully flexible C-shaped ring and the Metronic Duran ring which is fully flexible and circular. Both of these rings are also discussed in the Wright '279 patent. Because flexible annuloplasty rings can be hard for surgeons to manipulate and install due to their flexible nature, flexible rings typically require a holder for installation by a surgeon. However, fully attaching flexible annuloplasty rings to the circumference of a holder can present difficulties that require relatively tight tolerances between the annuloplasty rings and a holder and the connection process can drive up costs. In addition, known flexible suture rings require attachment of the entire inner circumferential surface of the annuloplasty ring to the holder, which can make it difficult to view the surgical field in the vicinity of a valve annulus and can inhibit access to all portions of the annuloplasty ring.
The present invention is directed toward overcoming one or more of the problems discussed above.